CARDIOVASCULAR DISEASE AMONG HISPANICS 4

PICOT statement: Can improving Hispanics’ standards of living be more effective in reducing the prevalence of cardiovascular diseases among Hispanics in the US starting six months from now?

Literature Review

Overview of the Hispanic Population in the US

According to the National Center for Biotechnology Information researchers Balfou et al. (2016), Hispanics (both Black and White) make up approximately 17% of the US population and their number is expected to be 30% by 2050. They are mainly concentrated in counties in the South Florida, Southwest and Northeast of the US. Hispanics occupy counties associated with high poverty rates and low living standards. They also have low mean levels of education attainment as compared to Caucasian Whites and African-Americans. This makes them less proficient in English than other races, which presents the issues of language barrier and social stereotypes. Furthermore, the locations in which Hispanics are densely populated have more than a third of the people lacking medical insurance cover, and the number of healthcare facilities and physicians in such communities is small (Balfou et al., 2016). Currently: 26.7% and 30.4% of Hispanic men and women have CVD respectively; Hispanics have 66% higher likelihood of suffering from CVD than Caucasian Whites; and 75% and 72% of Hispanic men and women are overweight or obese (Balfou et al., 2016). Furthermore, Three out of 4 Hispanics with diabetes are not aware that they are at risk of developing CVD, and 72% of Hispanics who experience stroke had hypertension (Balfou et al., 2016). From this information, demographic factors seem to be the major contributing reasons for the high prevalence of CVD among the Hispanic population in the US.

Nursing Science

Nursing science can substantially improve health management for the Hispanics by reducing health risk factors that contribute to high prevalence rates of CVD. According to Zaccagnini and White (2015), nursing science refers to patterns and methods of sourcing, comprehending, and appropriately applying scientific knowledge to improve health of individuals and populations. The authors also point out that nursing science involves the process of obtaining raw data, analyzing it and applying appropriate action research interventions to improve the health of individuals or populations. Zaccagnini and White (2015) argue that nursing science can be used to provide solutions to health issues that the conventional mechanistic medical models applied in contemporary primary care settings may not resolve. From the authors’ discussions, nursing science can be applied to study demographic and other characteristics of the Hispanic population to determine the main causes of CVD. Nurses can then consider the current interventions and their effectiveness so that they can make appropriate recommendations that can effectively reduce the prevalence rates of CVD among Hispanic Americans. Furthermore, nursing science can be applied in the follow-up processes so that nurses can reexamine the population to evaluate the progress of the applied interventions to determine its effectiveness, and if the target members of the population are adhering to the treatment plans. CARDIOVASCULAR DISEASE AMONG HISPANICS 4

Health Determinants and Epidemiological Data

Health determinants and epidemiological data can help manage CVD among Hispanics through enabling researchers to detect unhealthy lifestyles, cultures, or social conditions, and occurrence rates of CVD among the target population. Ruiz, Hamann, Mehl and O’Connor (2016) describe different social health determinants that Hispanics score poorly as comprising of social, physical, individual behaviors, and poor access to health. The authors raise concern that poverty rates among Hispanics is high and unequally balanced so that there are few rich individuals whereas the majority live below the poverty line. Ruiz et al. (2016) also found that there are few primary care facilities and healthcare workers versus the population of Hispanics in rural and urban low-class Hispanic communities. In their research, the authors found that the prevalence of racial discrimination and prejudice is experienced by Hispanics who seek medical care possibly due to their poor understanding of the English language. Ruiz et al. (2016) discuss low education levels as the main reason for Hispanics’ ignorance concerning lifestyle diseases, and irresponsible behaviors such as cigarette smoking and alcohol abuse. In their study, the authors found that most Hispanics do not engage in physically involving recreational activities, and their diet consists of large quantities of carbohydrates and fats. Furthermore, a significant number of families also take alcohol and cigarettes, which are known to induce development of type 2 diabetes (T2D). From the results of Ruiz et al.’s (2016) study, it is possible to create appropriate interventions for Hispanics since the main contributing factors to high prevalence CVD relate to social, physical, and economic determinants of health. The data on barriers to health can be analyzed to identify the specific behaviors and conditions that increase the likelihood of the development of CVD. After such factors have been identified, it will be possible to develop specific interventions for each barrier thereby making it possible to reduce CVD among Hispanics.

Genomic and Genetic Data

Williams et al. (2015) relate the prevalence of CVD with heredity and other determinants of health. On matters of genomics, the authors argue that clinically significant proportions of overweight and obese Hispanics cannot be attributed to social and physical determinant of health alone since genetic factors also play a role in the accumulation of body fat. The authors’ findings indicate that heredity plays a crucial role in the development of obesity especially among Hispanics with sedentary lifestyles. This means that Hispanics have genes that cause the overweight and obesity condition. From the findings, data can be compiled on the prevalence of gene-induced CVD and appropriate interventions such as early testing for genetic markers of CVD done for future management of CVD.

Overview of the Potential Solution

The predisposing factors to CVD among Hispanics in the US have been found to relate to socioeconomic, personal, and genetic determinants of health. As such, it is possible to create a comprehensive intervention strategy that addresses these barriers to health. The proposed solution to the issue is to advocate for improvement of Hispanics’ living standards through education and socioeconomic empowerment. The phrase that refer to the intervention in this case dubbed as “improvement of living standards” for this issue refers to a holistic approach that encompasses education, sociocultural risk-factor awareness, and economic empowerment. This intervention will result in sufficient concern and awareness of CVD among Hispanics, and will also lead to their economic empowerment so that they will be able to access and afford quality healthcare. This solution aligns with the PICOT in that it will help prevent CVD more than the conventional mechanistic medical interventions for CVP for Hispanics with CVD, and the timeline of two years is enough for the Hispanic population to remove the current barriers to CVD and realize better health. CARDIOVASCULAR DISEASE AMONG HISPANICS 4

How the Solution Supports Healthcare Equity for Hispanics

The approach, which is improvement of living standards of Hispanics through education and economic empowerment support healthcare equity by incorporating policies such as Universal healthcare, and education as basic human needs. Hispanics have low education attainment due to inequalities associated with racial discrimination and suppression, which is also the same when it comes to provision of quality medical services (Batalden et al., 2016). The program to improve the quality of life supports education and quality healthcare as fundamental human rights. Experts and policymakers in the education and health sectors will be involved in order to ensure that race and socioeconomic class-related biases have been removed within a period of two years to ensure that Hispanics in underprivileged socioeconomic conditions get access to quality education and healthcare.

References

Balfour Jr, P. C., Ruiz, J. M., Talavera, G. A., Allison, M. A., & Rodriguez, C. J. (2016). Cardiovascular disease in Hispanics/Latinos in the United States. Journal of Latina/o psychology, 4(2), 98-113.

Batalden, M., Batalden, P., Margolis, P., Seid, M., Armstrong, G., Opipari-Arrigan, L., & Hartung, H. (2016). Coproduction of healthcare service. BMJ Qual Saf, 25(7), 509-517.

Ruiz, J. M., Hamann, H. A., Mehl, M. R., & O’Connor, M. F. (2016). The Hispanic health paradox: from epidemiological phenomenon to contribution opportunities for psychological science. Group Processes & Intergroup Relations, 19(4), 462-476.

Williams, E. P., Mesidor, M., Winters, K., Dubbert, P. M., & Wyatt, S. B. (2015). Overweight and obesity: prevalence, consequences, and causes of a growing public health problem. Current obesity reports, 4(3), 363-370.

Zaccagnini, M., & White, K. (2015). The doctor of nursing practice essentials. London: Jones & Bartlett Learning.